title: Excess black mortality in the United States and in selected black and white high-poverty areas, 1980-2000.
abstract: OBJECTIVE
  Black working-aged residents of urban high-poverty areas suffered severe excess mortality in 1980 and 1990. Our goal in this study was to determine whether this trend persisted in 2000.
  
  
  METHODS
  We analyzed death certificate and census data to estimate age-standardized all-cause and cause-specific mortality among 16- to 64-year-old Blacks and Whites nationwide and in selected urban and rural high-poverty areas.
  
  
  RESULTS
  Urban men's mortality rate estimates peaked in 1990 and declined between 1990 and 2000 back to or below 1980 levels. Evidence of excess mortality declines among urban or rural women and among rural men was modest, with some increases. Between 1980 and 2000, there was little decline in chronic disease mortality among men and women in most areas, and in some instances there were increases.
  
  
  CONCLUSIONS
  In 2000, despite improved economic conditions, working-age residents of the study areas still died disproportionately of early onset of chronic disease, suggesting an entrenched burden of disease and unmet health care needs. The lack of consistent improvement in death rates among working-age residents of high-poverty areas since 1980 necessitates reflection and concerted action given that sustainable progress has been elusive for this age group.
authors.affiliation: Department of Health Behavior and Health Education, School of Public Health, and the Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, USA. arline@umich.edu
authors.forename: Arline T
authors.initials: AT
authors.lastname: Geronimus
authors.forename: John
authors.initials: J
authors.lastname: Bound
authors.forename: Cynthia G
authors.initials: CG
authors.lastname: Colen
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D002423:Cause of Death; D019352:Censuses; D003644:Death Certificates; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D011204:Poverty Areas; D012923:Social Class; D014481:United States / Q000453:epidemiology; D044465:White People; D055815:Young Adult